Chronic Myelogenous Leukemia
Conditions
Keywords
CML, STI571, imatinib, interferon, interferon alpha, cytosine arabinoside, chronic myeloid leukemia, Philadelphia chromosome positive
Brief summary
The purpose of this study is to evaluate and compare the side effects and anti-leukemic benefits of imatinib with those of interferon and Ara-C for patients who have chronic myeloid leukemia (CML) in the chronic phase. Patients in this study will be randomized (1:1) to receive either interferon plus Ara-C or imatinib as initial treatment.
Interventions
imatinib supplied as 100 mg and 400 mg tablets or 100 mg capsules.
interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m\^2/day.
cytarabine 20 mg/m\^2/day (max 40 mg) SC for 10 days every month.
Sponsors
Study design
Eligibility
Inclusion criteria
* Must have signed consent for Amendment 5 * Must have completed visit 62 of the core IRIS trial or be in follow-up * Must be on STI571 treatment * If on IFN treatment, must be willing to cross over to STI571 treatment
Exclusion criteria
* Patients who have discontinued from the study and are in follow-up * Patients who are on IFN treatment and do not want to cross over to STI571 treatment * Patients who have not consented to amendment 5 * Patients who did not complete the amendment 5 protocol Additional protocol-defined inclusion/
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 12,24,36,48,60,72,84,96,108,120,132 and 144 months | Overall survival was defined as the time between date of randomization and death due to any cause. The time was censored at last examination date for patients who were still being treated and at date of last contact for patients who discontinued treatment. Kaplan-Meier estimates of the percentage of participants at each time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Event Free Survival Events (All Randomized Participants) | 144 months | Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenic Response (MCyR) confirmed * loss of Major Cytogenic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). The percentage of participants with Event Free Survival events in each category was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment. |
| Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 12,24,36,48,60,72,84,96,108,120,132 and 144 months | Time to progression to AP/BC is defined as the time between randomization and either of the following events on treatment: death (due to CML when reported as primary reason for discontinuation of treatment) or progression to Accelerated Phase or Blast Crisis and is censored at last examination date for patients without event. No data after discontinuation of study treatment was included. The Kaplan Meier estimates of the percentage of participants with survival without progression to AP/BC at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment. |
| Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | 144 months | Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Philadelphia chromosome positive (Ph+) metaphases) and amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % of Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated. |
| Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | 144 months | Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Ph chromosome (Ph+) containing metaphases) and the amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated. |
| Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 12,24,36,48,60,72,84,96,108,120,132 and 144 months | Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenetic Response (MCyR) confirmed * loss of Major Cytogenetic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). Kaplan Meier estimates of the percentage of participants with Event Free Survival at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment. |
| Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment) | 144 months | A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant |
| Percentage of Participants With Major Molecular Response (First-line Treatment) | 12,24,36,48,60,72,84,96,108,120,132 and 144 months | Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale. |
| Percentage of Participants With Major Molecular Response (Second-line Treatment) | 12,24,36,48,60,72,84,96,108,120,132 and 144 months | Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale. |
| Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment) | 144 months | A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant |
Countries
Australia, Austria, Belgium, Canada, Denmark, France, Germany, Italy, Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Imatinib (STI571) In the first-line treatment period participants received imatinib 400 mg orally once daily in the morning. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10\^9/liter. If protocol specific criteria applied, participants were eligible to crossover to receive interferon-alpha (IFN-a) and cytarabine (ARA-C). Maximum study duration was 11.5 years. | 553 |
| IFN-a + Ara-C In the first-line treatment period participants received interferon-alpha (IFN-a) subcutaneous (SC) injections escalated over 4 weeks to achieve a target dose of 5 MU/m\^2/day. After the maximum tolerated dose of IFN-a was achieved, participants also received cytarabine (ARA-C) 20 mg/m\^2/day (max 40 mg) SC injections for 10 days every month. Hydroxyurea was permitted in the first 6 months to keep the white blood cell count (WBC) below 20.0 X 10\^9/liter. If protocol specific criteria applied, participants were eligible to crossover to the second-line treatment period to receive imatinib (CSI151). IFN treatment was discontinued with protocol amendment 6. Maximum study duration was 8 years. | 553 |
| Total | 1,106 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| First-line Treatment Period | Abnormal laboratory values | 3 | 1 | 0 | 0 |
| First-line Treatment Period | Abnormal procedure | 2 | 0 | 0 | 0 |
| First-line Treatment Period | Administrative problems | 12 | 6 | 0 | 0 |
| First-line Treatment Period | Adverse Event | 38 | 37 | 0 | 0 |
| First-line Treatment Period | Crossed over to other treatment arm | 14 | 363 | 0 | 0 |
| First-line Treatment Period | Death | 19 | 2 | 0 | 0 |
| First-line Treatment Period | Lost to Follow-up | 15 | 6 | 0 | 0 |
| First-line Treatment Period | No longer required study drug | 21 | 8 | 0 | 0 |
| First-line Treatment Period | Protocol Violation | 17 | 17 | 0 | 0 |
| First-line Treatment Period | Subject withdrew consent | 57 | 77 | 0 | 0 |
| First-line Treatment Period | Unsatisfactory therapeutic effect | 88 | 29 | 0 | 0 |
| Second-line Treatment Period | Abnormal Laboratory Values | 0 | 0 | 0 | 3 |
| Second-line Treatment Period | Abnormal procedure | 0 | 0 | 0 | 1 |
| Second-line Treatment Period | Administrative problems | 0 | 0 | 0 | 7 |
| Second-line Treatment Period | Adverse Event | 0 | 0 | 3 | 34 |
| Second-line Treatment Period | Death | 0 | 0 | 0 | 9 |
| Second-line Treatment Period | Lost to Follow-up | 0 | 0 | 0 | 6 |
| Second-line Treatment Period | No longer required study drug | 0 | 0 | 1 | 14 |
| Second-line Treatment Period | Protocol Violation | 0 | 0 | 1 | 10 |
| Second-line Treatment Period | Subject withdrew consent | 0 | 0 | 0 | 34 |
| Second-line Treatment Period | Unsatisfactory therapeutic effect | 0 | 0 | 9 | 70 |
Baseline characteristics
| Characteristic | Imatinib (STI571) | IFN-a + Ara-C | Total |
|---|---|---|---|
| Age Continuous | 50.0 years | 51.0 years | 51.0 years |
| Sex: Female, Male Female | 211 Participants | 243 Participants | 454 Participants |
| Sex: Female, Male Male | 342 Participants | 310 Participants | 652 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 541 / 551 | 531 / 533 | 13 / 14 | 347 / 363 |
| serious Total, serious adverse events | 226 / 551 | 163 / 533 | 2 / 14 | 160 / 363 |
Outcome results
Kaplan-Meier Estimates of Overall Survival (All Randomized Participants)
Overall survival was defined as the time between date of randomization and death due to any cause. The time was censored at last examination date for patients who were still being treated and at date of last contact for patients who discontinued treatment. Kaplan-Meier estimates of the percentage of participants at each time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 12 months (n = 553, 553) | 98.9 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 24 months (n = 542, 512) | 96.0 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 36 months (n = 518, 471) | 92.4 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 48 months (n = 492, 441) | 90.4 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 60 months (n = 475, 411) | 89.4 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 72 months (n = 461, 388) | 88.2 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 84 months (n = 446, 373) | 86.6 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 96 months (n = 430, 358) | 85.4 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 108 months (n = 391, 315) | 84.3 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 120 months (n = 368, 299) | 83.3 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 132 months (n = 356, 288) | 82.8 Percentage of participants |
| Imatinib (STI571) | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 144 months (n = 250, 199) | 81.3 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 132 months (n = 356, 288) | 77.7 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 12 months (n = 553, 553) | 97.7 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 84 months (n = 446, 373) | 83.1 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 24 months (n = 542, 512) | 93.6 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 120 months (n = 368, 299) | 78.8 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 36 months (n = 518, 471) | 89.8 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 96 months (n = 430, 358) | 81.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 48 months (n = 492, 441) | 87.7 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 144 months (n = 250, 199) | 75.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 60 months (n = 475, 411) | 85.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 108 months (n = 391, 315) | 79.9 Percentage of participants |
| IFN-a + Ara-C | Kaplan-Meier Estimates of Overall Survival (All Randomized Participants) | 72 months (n = 461, 388) | 83.8 Percentage of participants |
Kaplan Meier Estimates of Event Free Survival (All Randomized Participants)
Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenetic Response (MCyR) confirmed * loss of Major Cytogenetic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). Kaplan Meier estimates of the percentage of participants with Event Free Survival at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 12 months (n = 553, 553) | 96.6 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 24 months (n = 505, 332) | 89.6 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 36 months (n = 448, 263) | 85.3 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 60 months (n = 395, 223) | 83.2 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 72 months (n = 376, 207) | 83.0 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 84 months (n = 352, 181) | 82.0 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 96 months (n = 334, 166) | 81.0 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 108 months (n = 301, 141) | 79.9 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 120 months (n = 269, 130) | 79.6 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 132 months (n = 257, 124) | 79.6 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 48 months (n = 415, 241) | 83.9 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 144 months (n = 143, 76) | 79.6 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 48 months (n = 415, 241) | 63.7 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 12 months (n = 553, 553) | 79.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 96 months (n = 334, 166) | 58.3 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 24 months (n = 505, 332) | 70.0 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 132 months (n = 257, 124) | 56.6 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 36 months (n = 448, 263) | 67.0 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 108 months (n = 301, 141) | 56.6 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 60 months (n = 395, 223) | 61.9 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 144 months (n = 143, 76) | 51.8 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 72 months (n = 376, 207) | 60.1 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 120 months (n = 269, 130) | 56.6 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Event Free Survival (All Randomized Participants) | 84 months (n = 352, 181) | 59.0 Percentage of participants |
Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants)
Time to progression to AP/BC is defined as the time between randomization and either of the following events on treatment: death (due to CML when reported as primary reason for discontinuation of treatment) or progression to Accelerated Phase or Blast Crisis and is censored at last examination date for patients without event. No data after discontinuation of study treatment was included. The Kaplan Meier estimates of the percentage of participants with survival without progression to AP/BC at the given time point was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Population: Intent-to-treat population included all randomized participants. n = number of participants at risk at the beginning of the specific time interval
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 12 months (n = 553, 553) | 98.5 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 24 months (n = 513, 388) | 95.7 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 36 months (n = 461, 337) | 94.0 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 48 months (n = 431, 311) | 93.1 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 60 months (n = 409, 289 ) | 92.7 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 72 months (n = 384, 265) | 92.7 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 84 months (n = 358, 236) | 92.7 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 96 months (n = 338, 220) | 92.4 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 108 months (n = 305, 189) | 92.1 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 120 months (n = 272, 175) | 92.1 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 132 months (n = 259, 165) | 92.1 Percentage of participants |
| Imatinib (STI571) | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 144 months (n = 145, 94) | 92.1 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 132 months (n = 259, 165) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 12 months (n = 553, 553) | 92.9 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 84 months (n = 358, 236) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 24 months (n = 513, 388) | 90.0 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 120 months (n = 272, 175) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 36 months (n = 461, 337) | 87.9 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 96 months (n = 338, 220) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 48 months (n = 431, 311) | 84.7 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 144 months (n = 145, 94) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 60 months (n = 409, 289 ) | 83.5 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 108 months (n = 305, 189) | 82.4 Percentage of participants |
| IFN-a + Ara-C | Kaplan Meier Estimates of Time to Progression to Accelerated Phase (AP) or Blast Crisis (BC) (All Randomized Participants) | 72 months (n = 384, 265) | 83.1 Percentage of participants |
Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment)
A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant
Time frame: 144 months
Population: Safety Population included all randomized participants who received study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Imatinib (STI571) | Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment) | 226 Participants |
| IFN-a + Ara-C | Number of Participants With Serious Adverse Events as a Measure of Safety (First-line Treatment) | 163 Participants |
Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment)
A serious adverse event is any experience that suggests a significant hazard, contraindication, side effect or precaution that: results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or is medically significant
Time frame: 144 months
Population: Safety Population included all randomized participants who received study drug.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Imatinib (STI571) | Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment) | 2 Participants |
| IFN-a + Ara-C | Number of Participants With Serious Adverse Events as a Measure of Safety (Second-line Treatment) | 160 Participants |
Percentage of Participants With Best Cytogenetic Response (First-line Treatment)
Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Philadelphia chromosome positive (Ph+) metaphases) and amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % of Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.
Time frame: 144 months
Population: Intent-to-treat participants included all randomized participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Major Cytogenic Response | 89.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Complete Cytogenic Response | 82.8 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Partial Cytogenic Response | 6.1 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Major Cytogenic Response | 23.3 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Complete Cytogenic Response | 11.6 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (First-line Treatment) | Partial Cytogenic Response | 11.8 Percentage of participants |
Percentage of Participants With Best Cytogenetic Response (Second-line Treatment)
Bone marrow aspirate was performed to evaluate cytogenetic results (percentage of Ph chromosome (Ph+) containing metaphases) and the amount of blasts and promyelocytes in bone marrow to establish cytogenetic response. Major Cytogenetic Response= Complete Response or Partial Response. Complete Cytogenetic Response= 0 % of Ph+ metaphases (out of 20 metaphases). Partial Cytogenetic Response= \> 0 and ≤ 35 % Ph+ metaphases (out of 20 metaphases). The percentage of participants with cytogenetic response in each category was calculated.
Time frame: 144 months
Population: Intent-to-treat participants included all randomized participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Partial Cytogenic Response | 7.1 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Major Cytogenic Response | 14.3 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Complete Cytogenic Response | 7.1 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Complete Cytogenic Response | 81.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Partial Cytogenic Response | 5.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Best Cytogenetic Response (Second-line Treatment) | Major Cytogenic Response | 86.0 Percentage of participants |
Percentage of Participants With Event Free Survival Events (All Randomized Participants)
Event-free survival is defined as the time between randomization and the earliest of any of the following events on treatment: * progression to Accelerated Phase (AP) or Blast Crisis (BC) * loss of Complete Hematological Response (CHR) * loss of Major Cytogenic Response (MCyR) confirmed * loss of Major Cytogenic Response (MCyR) unconfirmed * increase in white blood cell count (WBC) if approved by the Study Management Committee (SMC) * death (due to any cause when reported as primary reason for discontinuation of treatment). The percentage of participants with Event Free Survival events in each category was calculated. This outcome was measured in all randomized patients, regardless of whether crossover occurred, i.e., events that occurred in patients, who had crossed over, were attributed following crossover to the original randomized treatment.
Time frame: 144 months
Population: Intent-to-treat population included all randomized participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of MCyR (confirmed) | 4.2 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Participants with events | 17.9 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of MCyR (unconfirmed) | 0.9 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Progression to AP or BC | 6.9 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Death | 3.1 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of CHR | 2.7 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Increase of WBC | 0.2 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of CHR | 7.6 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of MCyR (unconfirmed) | 1.1 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Increase of WBC | 3.4 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Death | 1.8 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Participants with events | 32.2 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Progression to AP or BC | 12.8 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Event Free Survival Events (All Randomized Participants) | Loss of MCyR (confirmed) | 5.4 Percentage of participants |
Percentage of Participants With Major Molecular Response (First-line Treatment)
Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Population: Intent-to-treat population included all randomized participants.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 12 months (n= 305, 83) | 50.2 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 24 months (n= 102, 12) | 69.6 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 36 months (n= 68, 7) | 76.5 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 48 months (n= 305, 12) | 77.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 60 months (n= 316, 10) | 88.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 72 months (n= 292, 9) | 88.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 84 months (n= 247, 8) | 91.9 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 96 months (n= 228, 4) | 92.5 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 108 months (n= 233, 0) | 93.6 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 120 months (n= 204, 0) | 93.1 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 132 months (n= 168, 0) | 92.3 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (First-line Treatment) | 144 months (n= 1, 0) | 100.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 132 months (n= 168, 0) | NA Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 12 months (n= 305, 83) | 9.6 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 84 months (n= 247, 8) | 87.5 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 24 months (n= 102, 12) | 25.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 120 months (n= 204, 0) | NA Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 36 months (n= 68, 7) | 28.6 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 96 months (n= 228, 4) | 100.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 48 months (n= 305, 12) | 58.3 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 144 months (n= 1, 0) | NA Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 60 months (n= 316, 10) | 100.0 Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 108 months (n= 233, 0) | NA Percentage of participants |
| IFN-a + Ara-C | Percentage of Participants With Major Molecular Response (First-line Treatment) | 72 months (n= 292, 9) | 88.9 Percentage of participants |
Percentage of Participants With Major Molecular Response (Second-line Treatment)
Major Molecular Response was determined using a quantitative polymerase chain reaction (PCR) laboratory test and was defined as BCR-ABL protein transcripts of ≤ 0.1% according to the international scale.
Time frame: 12,24,36,48,60,72,84,96,108,120,132 and 144 months
Population: Intent-to-treat population included all randomized participants. No participants in the imatinib to IFN-a + Ara-C arm were available for testing.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 12 months (n = 86) | 51.2 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 24 months (n = 62) | 69.4 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 36 months (n = 130) | 78.5 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 48 months (n = 216) | 81.9 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 60 months (n = 174) | 86.2 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 72 months (n = 146) | 91.1 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 84 months (n = 139) | 86.3 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 96 months (n = 138) | 87.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 108 months (n = 120) | 90.0 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 120 months (n = 84) | 85.7 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 132 months (n = 31) | 90.3 Percentage of participants |
| Imatinib (STI571) | Percentage of Participants With Major Molecular Response (Second-line Treatment) | 144 months | NA Percentage of participants |